At Spectrum Eyecare in Peachtree City, Dr. John Henahan is committed to reducing the number of people losing vision or becoming legally blind from macular degeneration (AMD). Please read this important information and discuss it with your doctor if your regularly take aspirin.

Discussing the new study, HealthDay (1/6, Mozes) reports, “Daily aspirin use among seniors may double their risk of developing” the “wet” form of “age-related macular degeneration (AMD), a significant cause of blindness in seniors,” according to a study published in the January issue of the journal Ophthalmology. In fact, “daily aspirin use was associated with the onset of late-stage” wet AMD, “and to a lesser degree, the onset of early ‘dry’ AMD — even after the researchers took into account age and a history of heart disease, which in itself is a risk factor for AMD.”

Specifically, “late-stage ‘wet’ AMD was 2.22 times more likely among daily aspirin users (95% CI 1.61 to 3.05) in a” study population of 4,691 European seniors, MedPage Today  (1/6, Phend) reports.

Medscape  (1/6, Keller) explains, “More frequent aspirin use was associated with more severe levels of AMD. One third of the individuals with wet AMD consumed aspirin daily compared with only 16% of control participants.” Medscape adds, “Limitations of the study include its cross-sectional and retrospective nature, with the possibility of recall error about aspirin use and possible confounders,” such as the fact that aspirin is found in many over-the-counter drugs that study participants might not have recognized as containing it. “In addition, there were no data on the doses of aspirin or the use of other antiplatelet or anticoagulant drugs” taken by study participants.

According to Dr. Henahan, the most recent data suggests a strong link between wet AMD and frequent Aspirin use.  ”I do NOT recommend that anyone discontinue aspirin use without consulting their physician or cardiologist” says Dr. Henahan.  ”The benefits of aspirin therapy must be balanced with the increased risk of wet AMD.  Consulting with your physician can help you decide what to do.”

If you or a loved one is concerned about the health of your eyes and live in the Peachtree City area, feel free to contact our office if you would like an appointment.  You may also call us at 770-487-0667.

After this father’s day weekend, I have been contemplating the unhappy news I had to deliver to my own father last week.

I discovered that his age-related macular degeneration (ARMD) had converted from the “dry” type to the “wet” type.  It was personally very difficult for me to deliver this news to my dad. It has also resulted in a lot of questions from my siblings about the nature of this condition.   I thought I would write the answers to their most frequently asked questions here, so they might be of some help to others as well.

What is ARMD?

ARMD is a deterioration of the central detail vision as a result of degeneration of the retina in the macular area.  The retina can be thought of as the film in the camera of the eye.  No matter what kind of lenses you have in the camera, if the film is damaged, you cannot take a clear picture.

Does ARMD cause blindness?

Since ARMD only affects the central detail vision, you can never go blind from ARMD.  However, you can lose your ability to see details.  For example, you could see the newspaper on the table but would struggle to read it.

How does someone get ARMD?

As the name implies, macular degeneration is age-related.  The prevalence increases steadily in each decade after age 60, with a prevalence of nearly 25% in those over age 90.

When other family members have/had ARMD you are more likely to develop ARMD yourself.  Other risk factors include a history of smoking, lots of sun exposure without the use of UV sunglasses and lightly colored eyes.

What is the difference between dry ARMD and wet ARMD?

Dry ARMD is by far the more common type.  It is characterized by the accumulation of creamy yellow deposits in the retina called drusen.  They eventually interfere with retinal function and can result in blurred central vision.

About 15% of the time, these same drusen can coalesce and then damage the layer of tissue underneath the retina, which causes the body to develop abnormal blood vessels in that area.  These blood vessels tend to bleed and leak (hence the “wet” in wet ARMD).  As this blood spills into the macular area of the retina, the retina swells.  The swelling impairs the function of the retina, causing a sudden deterioration in the central vision in that area.  In most cases, you would know right away that something was wrong when the blood vessels leak and bleed, because the change in vision is pronounced and sudden.

What is the Treatment for ARMD?

At this time there is no treatment for the dry type of ARMD.  Prevention is your best option (see below).

Until recently the treatment for wet ARMD involved the use of lasers to destroy the unwanted blood vessels.  The problem is that lasers create a lot of heat to do that, which invariably destroyed the retina above the vessels.  This left scar tissue and blind spots.  Now we have a new way of treating wet ARMD with medications that cause the blood vessels to regress and disappear.  As the blood vessels regress, the swelling in the retina would go down, often leading to modest improvements in vision.  More importantly, the treatment tends to prevent worsening of vision.

Can I prevent ARMD?

Since there is no treatment available for the more common dry ARMD, prevention is your best option.

A lifetime of sunglasses usage is a great starting point.  You can also take a multivitamin.

Additionally a supplement called Lutein has been shown to cut ARMD risk by 25-30%.  I recommend 20mg per day of natural form Lutein.

A large study of nurses completed in 2010 showed that those with the highest fish intake had the lowest reported severity of ARMD.  As such, I recommend 3000mg of high quality fish oil supplements per day.  (Take two capsules with breakfast and one with dinner).  Keep in mind that fish oil is very difficult to manufacture and lower quality fish oils are more likely to be rancid (if the pills stink, that is a sign they are rancid).

Finally if you smoke, quit.

How can I make the most of my remaining vision?

If you have have lost vision due to ARMD, you might benefit from low vision aids.  These specialized devices allow you to make the most of the vision you have left and can often help ARMD patients read better.  If the ARMD has only affected one eye, then low vision aids are not typically used.  They are usually only used when your vision is impaired in both eyes.

If you have questions about your vision, ARMD, or would like to find out if you are a candidate for low vision aids, feel free to contact Dr. Henahan at Spectrum Eyecare.  The website is www.speceye.com and the phone number is 770-487-0667.

Spring has finally sprung, and the pollen is diminishing to the point that you actually want to go outside, so it is time to consider how you will protect your eyes this summer.  We asked Dr. John Henahan of Spectrum Eyecare in Peachtree City to review the top things to look for when purchasing sunglasses.

1)   UV Protection. “Sunglasses are like sunscreen for your eyes”, says Dr. Henahan.  Protecting your eyes from UV is critical in reducing the likelihood that you will develop cataracts and macular degeneration, which are the leading causes of vision loss in Americans over age 65.  They can also protect against unattractive and sight threatening growths on the white part of the eye called a pterygium (“ter-ridge-e-um”).  It takes decades for UV light to cause this type of damage, so it is essential to protect your eyes starting in childhood. Most sunglasses in the US will be listed with a “UV400” designation that indicates it has UV protection.  More expensive sunglasses do not necessarily mean more UV protection, but rather relate to better optical clarity and higher quality frames.

2)   Polarized lenses.  There are two main types of lenses, polarized lenses and tinted lenses.  While both provide protection from UV light, tinted lenses merely reduce the brightness by darkening the lens.  This is far better than no protection at all, it doesn’t come close to the protection and glare reduction that you gain from polarized lenses.  Polarized lenses are tinted and they block 100% of the light rays from certain types of reflections including those on the water and when the sunglare that accompanies bright days.

3)   Optical Quality.  Although most lenses protect your eyes from UV light, the optical quality of a lens determines how sharp and distortion free your vision will be.  Generally speaking, fashion sunglasses (even expensive brands like Coach and D&G) will have lower optical quality than sports sunglasses, such as Costa del Mar, RayBan, Oakley and Maui Jim.  Costa del Mar is unique in offering the only second-generation polarized lenses.  These unique lenses block light all the way up to 580nm (vs 400nm for most sunglasses).  This allows for improved clarity of vision especially when looking into the water.  The 580nm lenses are prized by fisherman as well as others who spend a lot of time on the water.

4)   Lens Material.  Glass lenses provide the highest quality of vision, followed by plastic.  Although glass lenses are reasonably strong, they should not be purchased if protection from impact is a key consideration.  Polycarbonate is the strongest material and is a great choice for people such as military/law enforcement, construction workers, landscape company employees, etc.

5)   Lens Color.  Lenses most commonly come in gray, but are also seen in shades of brown as well as green.  In fact, the venerable RayBan Aviator worn by WWII pilots used a green lens (called G-15).  Generally brown lenses are best in overcast conditions, gray lenses excel on sunny days and the G-15 lenses balance the performance of brown and gray lenses.

Whatever you choose for sunglasses, keep in mind that none at all is the worst choice.  Polarized gray or brown sunglasses are the best choice for almost everyone, while tinted lenses are a great choice for pilots who cannot use polarized lenses in the cockpit.

Dr. John Henahan is a Peachtree City resident and founder of Spectrum Eyecare.  Visit his website at speceye.com for more information or contact us at 770-487-0667.

Dry Macular Degeneration is the number one cause of vision loss in Americans over age 65, according to Dr. John Henahan of Spectrum Eyecare in Peachtree City.  ”When I was director of low vision services at LSU Eye Center (in New Orleans), macular degeneration was the cause of vision impairment in more than 90% of my patients.”  The condition afflicts 10 to 15 million Americans.

To date, dry macular degeneration has been untreatable, so prevention is a primary focus. Perhaps that will change with stem cell therapy.  Bloomberg News reports “Advanced Cell Technology Inc. (ACT) is to test a therapy made from stem cells in patients with” age-related “macular degeneration (AMD). “Doctors will inject retinal cells made from stem cells into the eyes of 12 people with the dry form of macular degeneration.”

The Los Angeles Times reported that the “Phase I/II trial…would primarily test the safety of the cells and whether they are well-tolerated by patients.” Researchers “hope that these patients can be helped by the company’s retinal pigment epithelial (RPE) cells, which would theoretically replace the ones that have been destroyed by the disease. The RPE cells have restored vision in rats and mice with an animal version of the disease.”

The Worcester Telegram reported that “the trial is the second human study for” ACT. Back “in November, the company received approval from the Food and Drug Administration to test its cells in patients with Stargardt’s Disease, a form of juvenile macular degeneration.”

While this clinical trial brings hope for the millions who suffer from this condition or may suffer in the future, the best strategy is still one of prevention.  According to Dr. Henahan, use of UV protective sunglasses, fish oil, lutein and a multivitamin should be a mainstay of preventive efforts.  Additionally, smoking is a major risk factor for macular degeneration, so smoking cessation should be a top priority as well.  Finally, regular eye exams with a dilated retinal evaluation is critical, especially for patients over the age of 45.

If you or a family member are at risk for AMD, contact Spectrum Eyecare and Dr. Henahan in Peachtree City for a complete eye examination.  We will take the time to thoroughly examine your eyes and discuss the best ways to ensure a lifetime of healthy vision.

#1 Protect the future of your vision.  Vision loss is a leading cause of disability in older Americans.  By simply having an eye examination periodically, you can ensure that any eye health issues can be addressed before the problem becomes irreversible.  Remember, even if you don’t have vision insurance, a medically focused eye exam can usually be billed through your medical insurance. Proper nutrition is also a foundation for a lifetime of good vision.

#2 Wear Sunglasses. Quality polarized sunglasses with UV protection can cut the risk of cataracts, macular degeneration and even reduce the risk of skin cancers around the eyes.  Additionally, up to 30% of auto accidents are associated with glare induced vision impairment.  Polarized sunglasses are far more effective at cutting dangerous glare than tinted lenses alone when driving.  Polarized sunglasses are available with and without prescription lenses.

#3 Stop sleeping in your Contact Lenses. Study after study have shown that sleeping in contact lenses is the number one risk factor for serious complications from contact lenses including a potentially blinding eye infection called a corneal ulcer.  Even if your contact lenses are approved for extended wear, it is much safer to remove them at night.

#4 Throw Away those Contact Lenses (and that Contact Lens Case). After extended wear, keeping contact lenses for too long is the major risk for the aforementioned eye infections.  Most contact lenses are meant to be thrown away every two – four weeks.  As your contact lens ages, it is less able to provide enough oxygen to the surface of the eye.  This oxygen starvation can damage the surface of the eye.  Also, have you looked at your contact lens case lately?  Older cases are breeding grounds for bacteria.  Each time you buy a new bottle of solution, get a new case (some companies even bundle cases with large solution bottles).

#5 Resolve to give up your reading glasses. Are you a reading glasses addict? Do you have pairs spread around the house, car and office?  Always running around looking for a pair when your phone rings, when you need to read a menu, recipe or  to check your Facebook status?  There is a better way.  With a new generation of High-definition bifocal contact lenses and eyeglasses you can have good vision all the time; far away, close up and in between.  Imagine, no more taking on and off readers all day.

Whatever else you may do, Dr. Henahan recommends you resolve to see the best in yourself, others and the world around you.  Now that is a resolution we can all agree on!

Dr. John Henahan is a fellowship trained doctor of optometry practicing and living in Peachtree City with his wife and two sons.  You may call his office at 770 487-0667 or visit him on the web at www.speceye.com.

According to a recent post by Andrew Weil, MD multiple studies have again reiterated the importance of a nutrition and healthy diet in reducing the risk of Macular Degeneration, the leading cause of vision loss in older Americans.  ”Dr. Weil has been a real pioneer in integrative medicine”, according to Dr. John Henahan at Spectrum Eyecare in Peachtree City. “I have long worked to integrate nutrition counseling and judicious use of supplements to reduce the risk of eye disease and improve symptoms of various eye conditions”, continues Dr. Henahan.

“Researchers at the Agricultural Research Service (ARS)-funded Laboratory for Nutrition and Vision Research have found that the combination of a low-glycemic diet combined with vitamins C and E, zinc, lutein, zeaxanthin, and omega-3 fatty acids can help maintain quality of life and reduce health care costs due to sight-robbing eye diseases.”, reports Dr. Weil in his recent post.  A low glycemic diet has many other health benefits (Learn more). Omega-3 fatty acids, especially those found in fish oil have recently been reported to reduce the risk of macular degeneration markedly.  They also reduce dry eye symptoms in about 70% of patients.

Dr. Weil favors additional lifestyle and dietary changes to help reduce the risk of macular degeneration.  These include smoking cessation, sunglasses, and a diet rich in Vitamins, C, E as well as lutein and zinc.  According to Dr. Weil’s website, “Vitamin C-rich foods include citrus fruits, melons, tomatoes, potatoes and broccoli. You can get vitamin E from soybeans, greens, fish, wheat germ, nuts and seeds.Dietary sources of zinc are legumes (peas, dried beans, garbanzos/chickpeas, black-eyed peas, lentils and soy products) and whole grains. The carotenoid pigment lutein is found naturally in spinach, kale, collard greens, romaine lettuce and peas. Other protective compounds are the red and purple pigments found in berries and other fruit. Eat berries, especially blueberries, often. You can also get these pigments into your diet with supplements of bilberry, grape seed extract or pine bark extract. My recommendations for daily vitamin E are to take 400-800 IU of natural mixed tocopherols, or at least 80 mg of natural mixed tocopherols and tocotrienols. People under 40 should take 400 IUs a day; people over 40, 800 IUs.”

At Spectrum Eyecare, Dr. Henahan favors a preventive approach to macular degeneration.  ”You must act as soon as the earliest signs of macular pigment loss are apparent, which often occurs in the forties and fifties.  If you wait until macular degeneration is apparent, then it is too late to prevent it.  If your doctor is not looking carefully for signs of early macular pigment loss, called drusen, then you may be missing an opportunity to prevent this devestating condition.”, reports Dr. Henahan.  ”Look for health care professionals that want to partner with you to help you stay well, not wait until your eye is sick.”

In fact, according to the AOA American Eye-Q survey, only one-third of Americans said UV protection is the most important factor they consider when purchasing sunglasses.

Whether it’s cloudy or sunny, summer or winter, the AOA urges Americans to take measures to protect their eyes from the sun’s UV rays in order to decrease the risk of eye diseases and disorders.  “Over-exposure to UV rays is quite serious and can lead to cataracts, macular degeneration, or, in some cases, skin cancer around the eyelids,” said Sarah Hinkley, O.D., the AOA’s UV protection expert. “Other disorders that can occur are abnormal growths on the eye’s surface and even sunburn of the eyes. These conditions can cause blurred vision, irritation, redness, tearing, temporary vision loss and, in some instances, blindness.”

Even more troubling is the lack of awareness surrounding the potential effects of overexposure to UV radiation. According to the American Eye-Q survey, 35 percent of adults are unaware of the eye health risks associated with spending too much time in the sun without the proper protection.

The following top five tips from the AOA may help prevent eye and vision damage from over-exposure to UV radiation:

• Wear protective eyewear any time the eyes are exposed to UV rays.
• Look for quality sunglasses or contact lenses that offer good protection. Sunglasses should block 99 to100 percent of UV-A and UV-B radiation and screen out 75 to 90 percent of visible light.
• Check to make sure sunglass lenses are perfectly matched in color and free of distortions or imperfections.
• Purchase gray-colored lenses for the brightest conditions because they reduce light intensity without altering the color of objects to provide the most natural color vision. Choose brown or amber-colored lenses for variable light conditions, overcast days or times when you will be in and out of the shade such as hiking, golf or mountain biking.
• Don’t forget protection for young children and teenagers, who typically spend more time in the sun than adults and are at a greater risk for damage.

Children need UV Eye protection too

“The lenses of children’s eyes are more transparent than those of adults allowing shorter-wavelength light to reach the retina,” said Dr. Henahan. “Because the effects of solar radiation are cumulative, it’s important to develop good protection habits early, such as purchasing proper sunglasses for young children and teenagers.”

According to the AOA, parents should purchase sunglasses for all children, including infants.

The American Eye-Q survey found 66 percent of Americans purchase sunglasses for their children, but more than one in four parents do not check to make sure the lenses have proper UV protection. Additionally, less than one third (29 percent) of parents make sure their child wears sunglasses while outdoors.

Apart from an annual eye exam, the most important thing you can do to protect your eyes is to where quality polarized sunglasses, according to Dr. Henahan.  ”While I was director of Low Vision at LSU the majority of patients with vision impairment suffered from macular degeneration, which is caused in part by excess UV exposure.”  For maximum protection, Dr. Henahan recommends polarized lenses which have the added benefit of being much more effective at cutting glare.  ”When you are driving, on the water or participating in sports, the additional glare reduction afforded by polarized sunglasses is huge”, continues Dr. Henahan.  When purchasing sunglasses, you pay more for higher quality lenses, such as those made by Costa del Mar, Columbia and others.

If you would like more information or to see Dr. Henahan, click here or call the office at 770-487-0667.  He sees patients in Peachtree City every Monday, Wednesday, Friday and two Saturdays per month.

Large-scale study shows omega-3 fatty acids may lessen AMD severity

At Spectrum Eyecare in Peachtree City, Dr. John Henahan has long been an advocate for use of high quality fish oil in treating dry eye.  Now a new study from National Institutes of Health researchers found that those reporting the highest intake of omega-3 fatty acids (from fish oil) had the lowest reported rating of Age related Macular Degeneration (AMD) severity.

J.R. Chang, MD, and colleagues reported that “dietary DHA/EPA (the key components of fish oil) was inversely related to AMD score in energy-adjusted comparisons of participants reporting highest vs. lowest quintile intake.”  In other words, those with the highest level of fish oil intake had the lowest risk of AMD.

There were 4,203 patients in the study; they had a baseline mean age of 73 years; and 57% of the patients were women. All patients had good visual function at baseline, but the majority had risk factors for progression to advanced AMD, according to the poster.

“This is the strongest evidence yet that we can help reduce the severity or possibly even prevent macular degeneration in at risk patients with a strong nutritional program that includes fish oil, lutein and other vitamins”, according to Dr. Henahan.

“Historically, I have been recommending smoking cessation, polarized sunglasses, a multi-vitamin and 20mg of natural lutein per day.  But now I will be adding fish oil to my recommendations.  The great thing about fish oil is that it appears to have so many collateral benefits, such as reducing symptoms of dry eye, improving cholesterol levels and reducing the risk of cardiovascular events. However, those taking blood thinners (such as coumadin) should consult their physician before beginning fish oil”, continued Dr. Henahan.

When looking at fish oil supplements, it is important to shop very, very carefully.  Lower quality fish oils have increased contaminants such as lead or mercury and lower levels of the key omega-3′s called EPA and DHA.  Look for at least 40% of these components in each capsule.

At Spectrum Eyecare, Dr. Henahan takes the time to truly understand how he can work with patients to prevent the most serious eye diseases, especially through the use of nutritional supplements and other non-drug interventions.  Of course, he uses prescription medications when indicated, so you can be sure that you will get the best of both traditional and natural medicine to provide a lifetime of great vision.  If you would like to have Dr. Henahan evaluate you, please contact us by clicking here or calling 770-487-0667. Dr. Henahan is in the Peachtree City office every Monday, Wednesday and Friday as well as two Saturday’s per month.

Every year, more women than men are diagnosed with eye diseases such as dry eye, glaucoma, cataracts, macular degeneration and diabetic retinopathy, according to Dr. John L Henahan, of Spectrum Eyecare in Peachtree City, GA.

Of the many health differences between men and women, many may not be aware of the fact that women are more affected by eye disease and other eye conditions than men.

The 2008 “Vision Problems in the U.S.” study from Prevent Blindness America and the National Eye Institute consistently shows that more females are diagnosed with major eye diseases. Of the more than 3.6 million Americans age 40 and older suffering from visual impairment, including blindness, 2.3 million are women.

Women are also more susceptible to dry eye syndrome, a condition where not enough natural tears are produced.

Approximately 6 million women and 3 million men have moderate to severe symptoms of dry eye syndrome, according to the National Women’s Health Resource Center. It is more frequent in post-menopausal and pregnant women, due to hormonal fluctuations.

Women who are pregnant or receiving fertility treatments may experience changes in their vision. Because of an increase in hormones, some may notice refractive changes, dry eyes, puffy eyelids that obscure side vision and sensitivity to light due to migraine headaches.

Some vision changes in pregnant women, such as blurred vision and seeing spots, may be signs of a more serious problem and should be discussed with a doctor immediately as this may be a sign of pregnancy related diabetes or high blood pressure.

If you or someone you love  is diabetic and pregnant or  planning to become pregnant should get a full eye exam.

For older women, a recent study published in the March 2010 issue of Ophthalmology showed that women who are post menopausal and receiving Hormone Replacement Therapy (HRT) treatments may be at an increased risk for cataracts.  The study by Birgitta E. Lindblad, M.D., Sundsvall Hospital, Sweden, as part of the Swedish Mammography Cohort (SMC), states that of the more than 30,000 post- menopausal Swedish women studied who were using or had used HRT had significantly higher rates of cataract removal compared with women who had never used HRT. The “Hormone Replacement Therapy in Relation to Risk of Cataract Extraction: A Prospective Study of Women” data showed the risk for cataract removal was increased by 14 percent in women who had never used HRT and by 18 percent in current HRT users. And, longer duration of HRT use correlated with increased risk.

“Although more research needs to be completed regarding linking cataract increases with HRT, the message is clear that all women need to take the time to take care of their eyes today in order to maintain healthy vision in the future,” said Hugh R. Parry, president and CEO of Prevent Blindness America. “No matter what age you are, it’s never too early to start visiting your eye doctor and scheduling regular dilated eye exams.”

For more information, visit speceye.com or call 770-487-0667.

As the former director of Low Vision Services at LSU Medical school, Dr. John Henahan has always been passionate about helping the blind and those with visual impairments.  Fifteen years ago, that meant assisting patients to read printed material and move about without harming themselves.  An increasingly connected world risks leaving these patients further and further behind.

“It’s a visual digital divide”, says Dr. Henahan who still works with the visually impaired at Spectrum Eyecare in Peachtree city. “Although these patients have the means, they are being shut out of the opportunities presented by technologies like the Blackberry.  That is why I am so excited by the steps that Apple is taking with their ‘Accessibility‘ campaign.”

Apple computer, Inc. has long been an innovator in the personal computer, MP3 and more recently mobile phone space.  With the growing popularity of iPhones, touch screen iPods and the new iPad, Apple has quietly worked to enable their devices for those with visual impairments, such as macular degeneration, glaucoma, diabetic retinopathy, retinitis pigmentosa and Stargardt’s macular dystrophy among others.

At it’s heart, Apple has worked to create a series of simple to remember gestures that allow information on the screen of their Mac computer or Apple branded mobile device to be read aloud (This technology only works with Apple devices).  Apple has also ingeniously developed ways for the visually impaired to navigate the maze of applications, emails and other information on these devices.

If you know of someone who is visually impaired, take the time to learn more about Apple’s VoiceOver technology.  You can also click here to directly to a video demonstrating the VoiceOver on an iPhone. For those looking for a solution for their desktop Mac or Mac laptop, this video demonstrates how it works on a computer

For those in the Atlanta area looking for someone to evaluate and provide low vision services, feel free to contact us, or call 770-487-0667.